肺栓塞的诊断方法

Diagnosis of pulmonary embolism

肺栓塞在临床上较为常见,但诊断较困难。诊断应始于识别肺栓塞发生的危险因素及评估患者发生肺栓塞的可能性大小以及患者的临床症状和体征。常规的客观检查包括D-二聚体测定、心电图、胸片及超声心动图等。近年来,尚有人研究经食道超声在肺栓塞诊断中的价值。而且,随着影像学技术的发展,CT血管造影(CTA)、磁共振血管造影(MRA)及与其相关的一系列先进手段也逐渐应用于肺栓塞的诊断中,并显示出良好的应用前景。肺血管造影一直被认为是肺栓塞诊断的金标准,有人认为,多探测器螺旋CT(MDCT)的运用可能成为诊断肺栓塞的无创金标准,但结合临床的综合判断仍是诊断的基础。

Pulmonary embolism is comparatively common on clinic, but it is difficult to diagnose. Diagnosis should begin with recognizing risk factors of pulmonary embolism and assessing the possibility of pulmonary embolism and symptoms and signs of patients with pulmonary embolism. Routine examinations include D - dimer, electrocardiogram, chest X ray, and echocardiogram and so on. Along with the development of imaging technology, many advanced methods are also gradually applied in the diagnosis of pulmonary embolism and shows the good prospects. Pulmonary arteriography is a golden standard in the diagnosis of pulmonary embolism. Multidetector CT might be another one, but diagnosis based on clinical findings is usefui for pulmonary embolism.